Comparison of angioscopic, intravascular ultrasonic, and angiographic detection of thrombus in coronary stenosis

In the present study, different imaging modalities regarding their sensitivity and specificity in the detection of thrombus were compared. Using coronary angioscopy as the gold standard, both conventional angiography and ultrasound imaging exhibited a low sensitivity in detecting thrombus. In contrast, their specifity was rather high (87% and 100%) in the present study. These results curtail anecdotal reports of the value of ultraound imaging in the diagnosis of coronary thrombus. 6 Our results are in keeping with a study by den Heijer et al 7 who report a high specificty but low sensitivity for angiography versus angioscopy in detecting thrombus. Umans et al 8 who compared angiographic, ultrasonic, and angioscopic findings during atherectomy reported that all thrombi detected in 7 patients by angioscopy were not found by angiography or ultrasound. Thus, based on the increasing knowledge of thrombus formation on early and late success of coronary interventions, 9,10 angioscopy may be needed as the key adjunct tool for adequate strategy planning.